Healthcare Provider Details

I. General information

NPI: 1144836297
Provider Name (Legal Business Name): CHRISTOPHER WILLIAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2020
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 JESSE JEWELL PKWY SE
GAINESVILLE GA
30501-3763
US

IV. Provider business mailing address

6528 BERMUDA LN
FLOWERY BRANCH GA
30542-3109
US

V. Phone/Fax

Practice location:
  • Phone: 770-534-6959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHADS001043
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberHADS001043
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: